Can maternity cover taken with health insurance cut the cost?

(On a personal note, my wife and I will be welcoming our first child in April. We are not concerned about any extreme inpatient department (IPD) costs. Our health insurance policy will cover most hospitalization expenses because it has one maternity insurance the cover. we have already spent 75,000 in outpatient department (OPD) treatment, which includes routine doctor visits, diagnostic tests, COVID RTPCR tests, etc. However, our policy may not cover the entire OPD hospitalization cost. It will cover only 30 days pre-hospitalization cost and post hospitalization cost (up to 90 days). In addition, the total cost of . subject to the maximum limit of 50,000 including IPD cost. Still, we will save about 50-60% of the total maternity cost.)

Hence, choosing the right insurance policy is the first step towards cutting down on hospitalization costs. For example, a husband and wife having separate health covers with maternity insurance can save more as both can claim from their respective policies.

“In indemnity-based policies, you can claim expenses or losses from multiple policies, of course, subject to the terms and conditions of the policies. So, if both parents have maternity cover in their employer’s policies, they should be able to claim from both these policies,” said Mahaveer Chopra, Founder and CEO, Beshak.org.

As the cost of health care is increasing rapidly with every passing day, health policies with maternity cover can help you save on hospitalization expenses. Naval Goel, Founder and CEO, PolicyX.com said that these days the expenses are very high in view of the rising inflation. These policies help families bear the cost of various things related to childbirth and medical expenses of the newborn.

“However, since these policies come with a mandatory waiting period, it is imperative to choose maternity insurance carefully so that the policyholders can benefit,” he said.

Waiting Period: This is a period during which the insured cannot claim some or any policy benefit from the insurer. This period varies from insurer to insurer and policy to policy, but the typical waiting time for such a policy with maternity cover ranges from 9 months to 4 years. “For example, Care Health Insurance offers a policy called Joy Today, where the waiting period is nine months. But it is a three-year policy, which means you have to pay premiums for three years at a time. Hence, it is quite important to check the waiting period of your policy before claiming any medical-related expenses,” Goyal said.

Policy Coverage: Health insurance generally covers normal and caesarean deliveries along with maternity cover. It can come as a standalone policy and as an add-on cover with the base health policy (by paying some additional amount). Generally, a health insurance policy with maternity cover covers hospitalization expenses during both prenatal and postpartum stages, newborn baby expenses (up to 90 days), daycare treatment, newborn immunization expenses, ambulance expenses, cashless claim facilities etc. are included. However, this coverage completely depends on the type of policy and insurer you choose, and hence it may vary.

Rakesh Goel, Director, Probus Insurance, said, “Some of the common exclusions under this type of health coverage are pre-existing diseases that might affect the pregnancy, treatment expenses related to infertility, any medicinal expenses outside the scope of treatment, Pre- postpartum and postpartum expenses with no hospitalization, expenses involved in harvesting or storing stem cells, etc.”

Adding to this, Abhishek Mishra, CEO and Principal Officer, Bonanza Insurance said, “Women who are already pregnant are not eligible to buy these policies. Also, people who do not fall in the age group of 18-45 years also cannot buy such a policy.”

Sub-limits: Under the sub-limit clause, your insurance will cover only a certain amount of expenses for certain procedures. In other words, a sub-limit is a monetary limit that your insurer imposes on your medical insurance claim for specific coverage. They are often represented as a fixed amount, but can also be expressed as a specific percentage of the entire sum insured. Goyal said, “Most insurance companies usually limit their maternity payments. Generally, there are sub-limits for normal delivery from 15,000 25,000, whereas for caesarean it is anywhere 25,000 more 50,000 (this may vary depending on the type of policy and insurer).”

Cost of the policy: The cost of such policies depends on certain factors such as the type of insurance, age of the policyholders, area pin code, sum insured, etc. However, Goyal said, “The premium for such covers is mostly on the higher end. Since the certainty of the claim filed under this cover is high. You should do proper research and compare the options available online to find the ideal policy that suits both your needs and budget.”

Therefore, when you decide to buy this kind of coverage, you should do a detailed cost-benefit analysis between the different policies offered by different insurance providers.